level of prostate cancer diagnosis using mri-trus fusion biopsy in patients with a negative history of trus biopsy

Background: given the popularity of prostate specific antigen (psa) testing in recent years, the number of patients undergoing diagnostic prostate biopsy has increased. the transrectal ultrasound-guided (trus) biopsy is considered as the gold standard for prostate cancer detection, although has a low sensitivity. objectives: the current study aimed at enhancing prostate cancer diagnosis using mri-trus fusion biopsy in patients with negative history of trus biopsy. methods: in the current study, patients undergone trus prostate biopsy with benign results that were candidates for repeat biopsy were recruited. after making the preparations, patients underwent magnetic resonance imaging (mri)-trus fusion biopsy. gleason score, the number of involved cores, perineural invasion, perilymphovascular invasion, and the percentage of core involvement were recorded. results: of the 191 patients, 70(36.6%)hadpositive biopsies. thefrequency of non-detectable cancersbytargeted biopsy basedonthe level of cancer risk showed that at the very high-risk level, five (29.4%) and at high-risk level, two (11.7%) subjects were not recognized. the mean gleason score in targeted (7.470.99) and random (7.131.04) positive biopsies showed a significant difference between the two groups (p = 0.045). targeted biopsies are better than random ones to detect high-risk (33.9% vs 29.2%, p = 0.013 respectively) and very high-risk cancers (45.3% vs. 41.5%, p = 0.05 respectively). conclusions: the combination of both biopsy approaches is suggested to offer a reliable method with high rate of tumor detection.